Individual
SHANDA LYNN TALLANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2645 N LAUREL RD STE A, LONDON, KY 40741-9075
(833) 510-4357
(866) 460-2997
Mailing address
615 ELSINORE PL, CINCINNATI, OH 45202-1459
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
175102
KY
Other
Enumeration date
02/09/2021
Last updated
08/30/2022
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